Reimbursement Director
4 days ago
Under the general direction of the Executive Director, Corporate Controller, the Reimbursement Director is responsible for coordinating all CMS reporting requirements, including oversight of GME reporting functions. Additionally, this role involves the administration of the charge description master and revenue forecasting for both budget and month-end close. The Reimbursement Director will serve as the organization's expert on CMS regulatory changes and provide recommendations to senior management related to proposed changes. This role will also take the lead for the organization's Accounts Receivable review and analysis.
Minimum Job Qualifications- Licensure or other certifications: Bachelor's Degree in Business Administration, Finance, Accounting, or other related area
- Minimum Experience: Minimum five (5) to seven (7) years relevant work experience in healthcare financial management, including revenue modeling and CMS cost reporting activities
- Other:
- Preferred Licensure or other certifications: Master's degree or CPA
- Preferred Educational Requirements: Master's degree or CPA
- Preferred Experience: Operational experience as a Director in a health system
- Other:
- Ability to research complex coding, reimbursement, and regulatory requirements
- Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
- Must have a good understanding of the CDM and its relationship to related areas such as the General Ledger, Cost Accounting, Inventory, Productivity, Cost Reporting, and Budget
- Extensive knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations, DRGs, and APCs
- Understanding of Graduate Medical Education and healthcare financing issues
- Possess effective time management skills to permit handling of a large workload
- Ability to multi-task and work under aggressive deadlines
- Ability to understand and analyze payor contracts/regulations and model net revenue impacts based on reimbursement and coding guidelines
- Oversight of Charge Description Master functions and reimbursement analysis
- Supervision and coordination of Charge-master management functions in researching coding and billing guidelines, researching insurance contracts, and updating hospital Charge-master
- Works with the revenue-producing departments to ensure the ongoing coordinated consistency of the Charge-master, including accurate descriptions, coding, additions, deletions, pricing, charging methodology, and any other changes
- Collaborate with managerial and supervisory staff to ensure regulatory billing with correct coding on accounts
- Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines
- Monitor compliance with corporate, federal, and state guidelines
- Oversees all cost reporting to CMS for funding for GME programs in cooperation with the Finance Department
- Work with Finance to perform applicable analyses to understand net revenue effect of proposed Charge-master changes
- Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense, and charity write-offs and overall expense reduction
- Remain current with updated coding and billing regulations
- Prepares, monitors, and files Medicare and Medicaid Cost Reports assuring maximization of reimbursement from third-party payors
- Responds to surveys affecting Medicare and Medicaid rate revisions, interim payments, and hospital-based physician arrangements
- Monitors changes and proposed changes to Medicare and Medicaid regulations and determines the financial effect of these changes on the organization
- Coordinates financial audits conducted by CMS, DCH, and other governmental intermediaries on prior year's cost reports and surveys
- Provides management for Indigent Care Trust Fund processes and reporting
- Weight Lifted: Up to 20lbs, Occasionally 0-30%
- Weight Carried: Up to 20lbs, Occasionally 0-30%
- Vision: Moderate, Constantly 66-100%
- Kneeling/Stooping/Bending: Occasionally 0-30%
- Standing/Walking: Occasionally 0-30%
- Pushing/Pulling: Occasionally 0-30%
- Intensity of Work: Constantly 66-100%
- Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving
Working at Northeast Georgia Health System means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.
-
Reimbursement Director
4 weeks ago
Gainesville, Florida, United States Northeast Georgia Health System Full timeJob SummaryUnder the general direction of the Executive Director, Corporate Controller, this role is responsible for coordinating all CMS reporting requirements, including oversight of GME reporting functions. Additionally, the incumbent will administer the charge description master and revenue forecasting for both budget and month-end close. The ideal...
-
Care Management Director
4 weeks ago
Gainesville, Florida, United States HCA Florida North Florida Hospital Full timeDirector Respiratory Therapy Job DescriptionWe are seeking a highly skilled and experienced Director Respiratory Therapy to join our team at HCA Florida North Florida Hospital. As a key member of our healthcare team, you will be responsible for overseeing the respiratory therapy department and ensuring the delivery of high-quality patient care.Key...
-
Care Management Director
4 weeks ago
Gainesville, Florida, United States HCA Florida North Florida Hospital Full timeDirector Respiratory Therapy Job DescriptionWe are seeking a highly skilled and experienced Director Respiratory Therapy to join our team at HCA Florida North Florida Hospital. As a key member of our healthcare team, you will be responsible for overseeing the respiratory therapy department and ensuring the delivery of high-quality patient care.Key...
-
Activity Director
4 weeks ago
Gainesville, Florida, United States Cantex Continuing Care Network Full timeJob Summary:The Activity Director position at Cantex Continuing Care Network is responsible for creating engaging social and recreational programs for patients/residents. This role requires coordination, development, and maintenance of quality programs that provide mental and physical stimulation.Key Responsibilities:Assess patient/resident interests,...
-
Activity Director
2 weeks ago
Gainesville, Florida, United States Cantex Continuing Care Network Full timeJob Summary:The Activity Director position at Cantex Continuing Care Network is responsible for providing opportunities for patients/residents to engage in meaningful social and diversified special interest programs based on their needs, interests, capabilities, and previous lifestyles.Key Responsibilities:Assess each patient/resident for interests, talents,...
-
Clinical Director
2 weeks ago
Gainesville, Florida, United States Concierge Home Care Full timeJob OverviewConcierge Home Care is seeking a highly skilled Clinical Manager to oversee home health services in Gainesville, FL.The ideal candidate will have a strong background in nursing and experience in skilled, geriatric home health care.Key ResponsibilitiesSupervise home health services to patients in place of residence by physician ordersEnsure...
-
Program Coordinator I
2 weeks ago
Gainesville, Florida, United States InsideHigherEd Full timeJob SummaryWe are seeking a highly organized and detail-oriented Program Coordinator I to join our team in the Department of Surgery. The successful candidate will be responsible for maintaining records for past and present trainees, monitoring and documenting their progression towards graduation requirements, and preparing for regular meetings with program...
-
Gainesville, Florida, United States Northeast Georgia Health System Full timeJob Title: RN - Registered Nurse / Graduate Nurse - Medical CareJoin Northeast Georgia Health System as a Registered Nurse / Graduate Nurse - Medical Care and be part of a team dedicated to improving the health of our communities.About the Role:As a member of our Interdisciplinary Team, you will be responsible for assigned functions related to patient...
-
Hospice Certified Nursing Assistant
4 weeks ago
Gainesville, Florida, United States PruittHealth Full timePruittHealth Hospice Job DescriptionWe are seeking a compassionate and dedicated Certified Nursing Assistant (CNA) to join our team at PruittHealth Hospice. As a CNA, you will play a vital role in providing high-quality care to our patients and their families.Job SummaryThe CNA will be responsible for providing personal care services to patients, including...
-
Hospice Certified Nursing Assistant
4 weeks ago
Gainesville, Florida, United States PruittHealth Full timePruittHealth Hospice Job DescriptionWe are seeking a compassionate and dedicated Certified Nursing Assistant (CNA) to join our team at PruittHealth Hospice. As a CNA, you will play a vital role in providing high-quality care to our patients and their families.Job SummaryThe CNA will be responsible for providing personal care services to patients, including...
-
Gainesville, Florida, United States Northeast Georgia Health System Full timeJob Title: RN - Registered Nurse / Graduate Nurse - Medical CareJoin Northeast Georgia Health System as a Registered Nurse / Graduate Nurse - Medical Care and be part of a team dedicated to improving the health of our communities.About the Role:As a member of our Interdisciplinary Team, you will be responsible for assigned functions related to patient...
-
Residency Program Coordinator I
4 days ago
Gainesville, Florida, United States InsideHigherEd Full timeJob Title:Residency Program Coordinator I - Surgical EducationJob Summary:We are seeking a highly organized and detail-oriented Residency Program Coordinator I - Surgical Education to join our team. The successful candidate will be responsible for maintaining records for past and present trainees, monitoring and documenting progression towards graduation...
-
Gainesville, Florida, United States Northeast Georgia Health System Full timeJob Title: RN - Registered Nurse / Graduate Nurse - Medical CareJoin Northeast Georgia Health System as a Registered Nurse / Graduate Nurse - Medical Care and be part of a team dedicated to improving the health of our communities.About the Role:As a member of our Interdisciplinary Team, you will be responsible for assigned functions related to patient...
-
Logistics Coordinator
3 weeks ago
Gainesville, Florida, United States Pete & Gerry's Organics, LLC Full timeJob Title: Logistics AdministratorPete and Gerry's Organics is a leading provider of organic eggs, dedicated to the humane treatment of animals and sustainability. We're seeking a highly organized and detail-oriented Logistics Administrator to join our team.Job Summary:The Logistics Administrator will provide administrative support to the logistics team,...
-
EEG Technologist Gainesville
5 days ago
Gainesville, Florida, United States Neuro Pathway LLC Full timeAbout the JobWe are seeking a highly motivated and self-directed EEG technologist to join our team at Neuro Pathway LLC in Gainesville, FL.Job SummaryThe successful candidate will perform neurodiagnostic procedures under the supervision of our Director, Lead Technologist, and staff physicians. As an advanced competencies are completed, the technician may...
-
Certified Hospice Care Specialist
1 month ago
Gainesville, Florida, United States PruittHealth Full timePruittHealth Hospice Job DescriptionWe are seeking a compassionate and dedicated Certified Hospice Aide to join our team at PruittHealth Hospice in Gainesville. As a member of our interdisciplinary team, you will provide high-quality patient care and support to individuals and their families during a challenging time.Key Responsibilities:Provide personal...
-
Licensed Practical Nurse
4 weeks ago
Gainesville, Florida, United States SR COMPANIES LLC Full timeJob DetailsWe are seeking a compassionate and caring Licensed Practical Nurse (LPN) to provide excellent direct care to our residents on a daily basis.Responsibilities:Assist in admission of new residents and perform assigned nursing procedures for their comfort and well-being.Administer specified medications and supervise non-licensed nursing...
-
EEG Technologist Gainesville
1 month ago
Gainesville, Florida, United States Neuro Pathway LLC Full timeAbout the JobWe are seeking a highly motivated and self-directed EEG Technologist to join our team at Neuro Pathway LLC in Gainesville, FL.Job SummaryThe successful candidate will perform neurodiagnostic procedures under the supervision of our Director, Lead Technologist, and staff physicians. As advanced competencies are completed, the technician may...
-
EEG Technologist Gainesville
4 weeks ago
Gainesville, Florida, United States Neuro Pathway LLC Full timeAbout the JobWe are seeking a highly motivated and self-directed EEG Technologist to join our team at Neuro Pathway LLC in Gainesville, FL.Job SummaryThe successful candidate will perform neurodiagnostic procedures under the supervision of our Director, Lead Technologist, and staff physicians. As an advanced technologist, you will have the opportunity to...
-
Fitness Instructor
4 days ago
Gainesville, Florida, United States US Fitness Full timeJob SummaryThe Group Fitness Instructor is responsible for delivering exceptional fitness experiences to our members, promoting services to drive membership growth, and providing a positive group fitness environment under the guidance of the Group Fitness Director and in collaboration with the Group Fitness team.Key ResponsibilitiesDesign and deliver...
